Department of Medicine, University of Turku, Turku, Finland2Division of Medicine, Turku University Hospital, Turku, Finland3Murdoch Childrens Research Institute and Royal Children's Hospital, Melbourne, Australia.
Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland5Unit of Personality, Work and Health, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland6Helsinki Collegium for Advanced Studies, University of He.
JAMA Pediatr. 2016 May 1;170(5):466-72. doi: 10.1001/jamapediatrics.2015.4121.
There is increasing evidence supporting the importance of psychosocial factors in the pathophysiology of atherosclerotic disease. They have been shown to be associated with the population attributable risk for myocardial infarction.
To determine if a score of favorable childhood psychosocial factors would be associated with decreased coronary artery calcification in adulthood.
DESIGN, SETTING, AND PARTICIPANTS: The analyses were performed in 2015 using data gathered in 1980 and 2008 within the longitudinal Cardiovascular Risk in Young Finns Study. The data source consisted of 311 individuals who had psychosocial factors measured at ages 12 years to 18 years and coronary artery calcification measured 28 years later in adulthood. The summary measure of psychosocial factors in childhood comprised measures of socioeconomic factors, emotional factors, parental health behaviors, stressful events, self-regulation of the child, and social adjustment of the child.
Coronary artery calcification at ages 40 years to 46 years.
Of the 311 participants, 48.2% were men. Of the participants, 55 (17.7%) had some calcium observed in their coronary arteries. A 1-SD increase in a favorable summary score of childhood psychological factors was associated with an adulthood coronary artery calcification probability of 0.85 (95% CI, 0.76-0.95) (P = .006). This inverse relationship remained significant after adjustment for age, sex, and conventional childhood risk factors (0.85; 95% CI, 0.74-0.97; P = .02) or for age, sex, adulthood conventional cardiovascular risk factors, socioeconomic status, social support, and depressive symptoms (0.83; 95% CI, 0.71-0.97; P = .02).
In this longitudinal study, we observed an independent association between childhood psychosocial well-being and reduced coronary artery calcification in adulthood. A positive childhood psychosocial environment may decrease cardiovascular risk in adulthood and may represent a potentially modifiable risk determinant.
越来越多的证据支持心理社会因素在动脉粥样硬化疾病发病机制中的重要性。这些因素已被证明与心肌梗死的人群归因风险相关。
确定良好的儿童心理社会因素评分是否与成年后冠状动脉钙化减少有关。
设计、设置和参与者:2015 年,在纵向心血管风险在年轻芬兰人研究中,使用 1980 年和 2008 年收集的数据进行了分析。数据源由 311 名在 12 至 18 岁时测量过心理社会因素且 28 年后在成年时测量过冠状动脉钙化的个体组成。儿童时期心理社会因素的综合测量包括社会经济因素、情绪因素、父母健康行为、压力事件、儿童自我调节和儿童社会适应的衡量标准。
40 至 46 岁时的冠状动脉钙化。
在 311 名参与者中,48.2%为男性。其中 55 人(17.7%)的冠状动脉有一些钙沉积。儿童时期有利心理因素综合评分每增加 1 个标准差,与成年后冠状动脉钙化的概率为 0.85(95%CI,0.76-0.95)(P=0.006)相关。在调整年龄、性别和传统儿童危险因素后(0.85;95%CI,0.74-0.97;P=0.02)或调整年龄、性别、成年常规心血管危险因素、社会经济地位、社会支持和抑郁症状后(0.83;95%CI,0.71-0.97;P=0.02),这种反比关系仍然显著。
在这项纵向研究中,我们观察到儿童期心理社会幸福感与成年后冠状动脉钙化减少之间存在独立关联。积极的儿童心理社会环境可能会降低成年后的心血管风险,并且可能代表一种潜在的可改变的风险决定因素。